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Influence of patient‐specific factors when comparing multifidus fat infiltration between chronic low back pain patients and asymptomatic controls

Ballatori, Alexander M. and Shahrestani, Shane and Nyayapati, Priya and Agarwal, Vibhu and Krug, Roland and Han, Misung and Fields, Aaron J. and O'Neill, Conor and Demir-Deviren, Sibel and Lotz, Jeffrey C. and Bailey, Jeannie F. (2022) Influence of patient‐specific factors when comparing multifidus fat infiltration between chronic low back pain patients and asymptomatic controls. JOR SPINE . ISSN 2572-1143. doi:10.1002/jsp2.1217. (In Press) https://resolver.caltech.edu/CaltechAUTHORS:20220801-490104000

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Abstract

Introduction. Many studies have attempted to link multifidus (MF) fat infiltration with muscle quality and chronic low back pain (cLBP), but there is no consensus on these relationships. Methods. In this cross-sectional cohort study, 39 cLBP patients and 18 asymptomatic controls were included. The MF muscle was manually segmented at each lumbar disc level and fat fraction (FF) measurements were taken from the corresponding advanced imaging water-fat images. We assessed the distribution patterns of MF fat from L1L2 to L5S1 and compared these patterns between groups. The sample was stratified by age, sex, body mass index (BMI), subject-reported pain intensity (VAS), and subject-reported low back pain disability (oswestry disability index, ODI). Results. Older patients had significantly different MF FF distribution patterns compared to older controls (p < 0.0001). Male patients had 34.8% higher mean lumbar spine MF FF compared to male controls (p = 0.0006), significantly different MF FF distribution patterns (p = 0.028), 53.7% higher mean MF FF measurements at L2L3 (p = 0.037), and 50.6% higher mean MF FF measurements at L3L4 (p = 0.041). Low BMI patients had 29.7% higher mean lumbar spine MF FF compared to low BMI controls (p = 0.0077). High BMI patients only had 4% higher mean lumbar spine MF FF compared to high BMI controls (p = 0.7933). However, high BMI patients had significantly different MF FF distribution patterns compared to high BMI controls (p = 0.0324). Low VAS patients did not significantly differ from the control cohort for any of our outcomes of interest; however, high VAS patients had 24.3% higher mean lumbar spine MF FF values (p = 0.0011), significantly different MF FF distribution patterns (p < 0.0001), 34.7% higher mean MF FF at L2L3 (p = 0.040), and 34.6% higher mean MF FF at L3L4 (p = 0.040) compared to the control cohort. Similar trends were observed for ODI. Conclusions. This study suggests that when the presence of paraspinal muscle fat infiltration is not characteristic of an individual's age, sex, and BMI, it may be associated with lower back pain.


Item Type:Article
Related URLs:
URLURL TypeDescription
https://doi.org/10.1002/jsp2.1217DOIArticle
https://onlinelibrary.wiley.com/action/downloadSupplement?doi=10.1002%2Fjsp2.1217&file=jsp21217-sup-0001-supinfo.docPublisherData
ORCID:
AuthorORCID
Ballatori, Alexander M.0000-0002-2819-3831
Shahrestani, Shane0000-0001-7561-4590
Agarwal, Vibhu0000-0002-6392-3924
Han, Misung0000-0003-0918-8831
Fields, Aaron J.0000-0001-6460-4506
Demir-Deviren, Sibel0000-0001-5642-3625
Lotz, Jeffrey C.0000-0002-9654-0647
Bailey, Jeannie F.0000-0003-4618-7512
Additional Information:© 2022 The Authors. JOR Spine published by Wiley Periodicals LLC on behalf of Orthopaedic Research Society. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. Version of Record online: 14 July 2022. Manuscript accepted: 26 June 2022. Manuscript revised: 17 June 2022. Manuscript received: 28 November 2021. Alexander M. Ballatori designed, collected and analyzed the data, and wrote the manuscript. Shane Shahrestani conducted all the statistical analyses. Priya Nyayapati collected data. Vibhu Agarwal assisted in study design and statistical analysis. Roland Krug and Misung Han developed the images for this study. Aaron J. Fields, Conor O'Neill, and Sibel Demir-Deviren aided in patient acquisition and data analysis. Jeffrey C. Lotz received funding for this work, contributed to design of the study, and aided in revising the manuscript. Jeannie F. Bailey designed, collected, and analyzed the data, as well as revising the manuscript with Alexander M. Ballatori. All authors have read and approve of the final manuscript. The authors declare no conflicts of interest. Funding information: National Institute of Health (NIH), Grant/Award Number: NIHR01AR63705.
Funders:
Funding AgencyGrant Number
NIHR01AR63705
Subject Keywords:chronic low back pain; fat infiltration; IDEAL; multifidus
DOI:10.1002/jsp2.1217
Record Number:CaltechAUTHORS:20220801-490104000
Persistent URL:https://resolver.caltech.edu/CaltechAUTHORS:20220801-490104000
Official Citation:Ballatori, A. M., Shahrestani, S., Nyayapati, P., Agarwal, V., Krug, R., Han, M., Fields, A. J., O'Neill, C., Demir-Deviren, S., Lotz, J. C., & Bailey, J. F. (2022). Influence of patient-specific factors when comparing multifidus fat infiltration between chronic low back pain patients and asymptomatic controls. JOR Spine, e1217. https://doi.org/10.1002/jsp2.1217
Usage Policy:No commercial reproduction, distribution, display or performance rights in this work are provided.
ID Code:115997
Collection:CaltechAUTHORS
Deposited By: George Porter
Deposited On:02 Aug 2022 14:22
Last Modified:02 Aug 2022 14:22

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